CAJ | 학술논문

目的：探讨腰大池持续引流对创伤性蛛网膜下腔出血（tSAH）患者局部脑代谢、认知功能障碍及临床预后的影响。方法57例 tSAH 患者随机分为两组，（1）常规治疗组：28例，给予常规治疗；（2）腰大池引流组：29例，自伤后第3 d 起在常规治疗的基础上给予腰大池持续引流处理。另设10例交通事故外伤患者（头颅 CT 检查未见脑挫裂伤及脑出血）为对照组。3组患者分别于伤后第10 d 和治疗后3个月门诊随访时行磁共振波谱（MRS）检查、临床痴呆量表（CDR）评分，且常规治疗组和腰大池引流组患者于治疗后3个月门诊随访时行格拉斯哥预后量表（GOS）评分。结果伤后第10 d，与常规治疗组比较腰大池引流组的 MRS NAA ／Cr、NAA ／Cho 增高，Cho ／Cr 降低，差异有统计学意义（均 P ＜0．05）。治疗后3个月，与常规治疗组比较腰大池引流组的 CDR 评分减低，GOS 评分高，差异有统计学意义（均 P ＜0．05）。结论腰大池持续引流能改善 tSAH 患者的局部脑组织代谢及认知功能，改善患者的预后。
목적：탐토요대지지속인류대창상성주망막하강출혈（tSAH）환자국부뇌대사、인지공능장애급림상예후적영향。방법57례 tSAH 환자수궤분위량조，（1）상규치료조：28례，급여상규치료；（2）요대지인류조：29례，자상후제3 d 기재상규치료적기출상급여요대지지속인류처리。령설10례교통사고외상환자（두로 CT 검사미견뇌좌렬상급뇌출혈）위대조조。3조환자분별우상후제10 d 화치료후3개월문진수방시행자공진파보（MRS）검사、림상치태량표（CDR）평분，차상규치료조화요대지인류조환자우치료후3개월문진수방시행격랍사가예후량표（GOS）평분。결과상후제10 d，여상규치료조비교요대지인류조적 MRS NAA ／Cr、NAA ／Cho 증고，Cho ／Cr 강저，차이유통계학의의（균 P ＜0．05）。치료후3개월，여상규치료조비교요대지인류조적 CDR 평분감저，GOS 평분고，차이유통계학의의（균 P ＜0．05）。결론요대지지속인류능개선 tSAH 환자적국부뇌조직대사급인지공능，개선환자적예후。
Objective To explore the effect of lumbar continuous drainage on regional cerebral metabolism,cognitive dysfunction and clinical outcomes in patients with traumatic subarachnoid hemorrhage(tSAH).Methods 57 patients with tSAH were randomly divided into two groups,28 were in conventional treatment group and 29 in conventional treatment and lumbar continuous drainage (LCD)group(lumbar drainage group).Another 10 cases of traffic accident injury patients(without brain contusion and hemorrhage on CT)were in control group.Three groups of patients accepted magnetic resonance spectroscopy(MRS)examination and clinical dementia scale (CDR)on 10th day after traumatic brain injury and clinical follow-up after treatment for 3 months.Conventional treatment group and lumbar drainage group accepted GOS scale at clinical follow-up after treatment for 3 months.Results Compared with conventional treatment group,MRS NAA/Cr,NAA/Cho were significantly higher and Cho /Cr were significantly lower in lumbar drainage group at 10th day after traumatic brain injury(all P <0.05).Compared with conventional treatment group,CDR scores were significant lower and GOS scores were significantly higher in lumbar drainage group after treatment for 3 months(all P <0.05).Conclusions LCD can improve the regional cerebral metabolism,cognitive dysfunction and clinical outcomes of patients with traumatic tSAH.